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Organization

OLD MOULTRIE SURGICAL CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GEORGE EDWARD SADOWSKI MD (MEDICAL DIRECTOR)
(904) 797-6627
Entity
Organization

Contact information

Practice address
2460 OLD MOULTRIE ROAD, SUITE 3, ST AUGUSTINE, FL 32086-4198
(904) 797-6627
(904) 797-6028
Mailing address
P O BOX 3127, ST AUGUSTINE, FL 32085-3127
(904) 797-6627
(904) 797-6028

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1089
FL

Other

Enumeration date
09/15/2006
Last updated
08/03/2009
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